﻿<%@ Page Title="Registration" Language="C#" MasterPageFile="~/Site.Master" AutoEventWireup="true" CodeBehind="Registration.aspx.cs" Inherits="Internet_Deliver_Therapy.View.Index.Registration" %>
<asp:Content ID="Content1" ContentPlaceHolderID="MainContent" runat="server">
    <h1>E-LEARNING REGISTRATION</h1>
    <p>Page 1 of 3</p>
    <p style="language:en-SG;margin-top:0pt;margin-bottom:0pt;margin-left:0in">
        <span style="font-size:9.0pt;font-family:&quot;Century Gothic&quot;;mso-ascii-font-family:&quot;Century Gothic&quot;;
mso-fareast-font-family:&quot;Century Gothic&quot;;mso-bidi-font-family:&quot;Century Gothic&quot;;
language:en-SG">Welcome to </span><span style="font-size:9.0pt;font-family:
&quot;Century Gothic&quot;;mso-ascii-font-family:&quot;Century Gothic&quot;;mso-fareast-font-family:
&quot;Century Gothic&quot;;mso-bidi-font-family:&quot;Century Gothic&quot;;language:en-SG;
font-weight:bold">our e-learning pilot program</span><span style="font-size:
9.0pt;font-family:&quot;Century Gothic&quot;;mso-ascii-font-family:&quot;Century Gothic&quot;;
mso-fareast-font-family:&quot;Century Gothic&quot;;mso-bidi-font-family:&quot;Century Gothic&quot;;
language:en-SG"> on Depression! This program will last for 12 weeks. You will receive one module each week containing reading materials, assignments and exercises which you will have to complete. A therapist will be tracking your progress and can be contacted via email should you need any assistance. We hope that you would see improvement in your mood and thought pattern after the course and wish you the very best of luck with our e-program!</span></p>
    <p style="language:en-SG;line-height:150%;margin-top:0pt;margin-bottom:0pt;
margin-left:0in">
        <span style="font-size:9.0pt;font-family:&quot;Century Gothic&quot;;
mso-ascii-font-family:&quot;Century Gothic&quot;;mso-fareast-font-family:&quot;Century Gothic&quot;;
mso-bidi-font-family:&quot;Century Gothic&quot;;language:en-SG;font-weight:bold">Kindly provide us with the following details.</span></p>
    <p style="language:en-SG;line-height:150%;margin-top:0pt;margin-bottom:0pt;
margin-left:0in">
        &nbsp;</p>
    <p style="language:en-SG;line-height:150%;margin-top:0pt;margin-bottom:0pt;
margin-left:0in">
        <span style="font-size:8.0pt;font-family:&quot;Century Gothic&quot;;
mso-ascii-font-family:&quot;Century Gothic&quot;;mso-fareast-font-family:&quot;Century Gothic&quot;;
mso-bidi-font-family:&quot;Century Gothic&quot;;color:red;language:en-SG;mso-style-textfill-type:
solid;mso-style-textfill-fill-color:red;mso-style-textfill-fill-alpha:100.0%">*Mandatory </span><span style="font-size:8.0pt;font-family:&quot;Century Gothic&quot;;mso-ascii-font-family:
&quot;Century Gothic&quot;;mso-fareast-font-family:&quot;Century Gothic&quot;;mso-bidi-font-family:
&quot;Century Gothic&quot;;color:red;language:en-SG;mso-style-textfill-type:solid;
mso-style-textfill-fill-color:red;mso-style-textfill-fill-alpha:100.0%">field</span><span style="font-size:8.0pt;font-family:&quot;Century Gothic&quot;;mso-ascii-font-family:&quot;Century Gothic&quot;;
mso-fareast-font-family:&quot;Century Gothic&quot;;mso-bidi-font-family:&quot;Century Gothic&quot;;
color:red;language:en-US;mso-style-textfill-type:solid;mso-style-textfill-fill-color:
red;mso-style-textfill-fill-alpha:100.0%"> *Password has to be alpha numeric with min. 6 characters</span></p>
    <article>
     <p class="text-danger">
        <asp:Literal runat="server" ID="ErrorMessage" />
    </p>
    <asp:ValidationSummary runat="server" CssClass="text-danger" />
    <asp:Table ID="Table1" runat="server" Width="1100px">
        <asp:TableRow>
            <asp:TableCell>
                <asp:Label ID="Label1" runat="server" Text="First Name (Given Name)*"></asp:Label><asp:TextBox ID="tbFirstName" runat="server" Text="Eileen"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbFirstName" CssClass="text-danger" ErrorMessage="The First Name field is required." />
            </asp:TableCell>
            <asp:TableCell>
                <asp:Label ID="Label2" runat="server" Text="Gender*"></asp:Label><asp:DropDownList ID="ddlGender" runat="server" />
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>    
                <asp:Label ID="Label3" runat="server" Text="Last Name (Surname)*"></asp:Label><asp:TextBox ID="tbLastName" runat="server" Text="Tan"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbLastName" CssClass="text-danger" ErrorMessage="The Last Name field is required." />
            </asp:TableCell>
            <asp:TableCell>
                <asp:Label ID="Label4" runat="server" Text="Race*"></asp:Label><asp:TextBox ID="tbRace" runat="server" Text="Chinese"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbRace" CssClass="text-danger" ErrorMessage="The Race field is required." />
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>    
                <asp:Label ID="Label5" runat="server" Text="NRIC/Fin*"></asp:Label><asp:TextBox ID="tbNRIC" runat="server" Text="S0987654C"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbNRIC" CssClass="text-danger" ErrorMessage="The NRIC/Fin field is required." />
            </asp:TableCell>
            <asp:TableCell>
                <asp:Label ID="Label6" runat="server" Text="Birth Date*"></asp:Label><select id="daydropdown" name="daydropdown"></select><select id="monthdropdown" name="monthdropdown"></select><select id="yeardropdown" name="yeardropdown"></select>
                <script type="text/javascript">
                    window.onload = function () {
                        populatedropdown("daydropdown", "monthdropdown", "yeardropdown")
                    }
                </script>
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>    
                <asp:Label ID="Label7" runat="server" Text="Mobile No.*"></asp:Label><asp:TextBox ID="tbMobileNo" runat="server" Text="91234567"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbMobileNo" CssClass="text-danger" ErrorMessage="The Mobile No. field is required." />
            </asp:TableCell>
            <asp:TableCell>
                <asp:Label ID="Label8" runat="server" Text="Home No."></asp:Label><asp:TextBox ID="tbHomeNo" runat="server" Text="61234567"></asp:TextBox>
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>
                <asp:Label ID="Label9" runat="server" Text="Email Address*"></asp:Label><asp:TextBox ID="tbEmail" runat="server" Text="eileen@gmail.com"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbEmail" CssClass="text-danger" ErrorMessage="The Email field is required." />
                <asp:RegularExpressionValidator runat="server" ControlToValidate="tbEmail" CssClass="text-danger" Display="Dynamic" 
                    ValidationExpression="\w+([-+.]\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*" ErrorMessage="Please enter a valid Email" />
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>
                <asp:Label ID="Label10" runat="server" Text="Password*"></asp:Label><asp:TextBox ID="tbPassword" runat="server" TextMode="Password"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbPassword" CssClass="text-danger" ErrorMessage="The Password field is required." />
                <asp:RegularExpressionValidator runat="server" ControlToValidate="tbPassword" CssClass="text-danger" Display="Dynamic"
                    ValidationExpression="(?=^.{6,}$)(?=(?:.*?\d){1})(?=.*[a-z])(?=(?:.*?[!@#$%*()_+^&}{:;?.]){1})(?!.*\s)[0-9a-zA-Z!@#$%*()_+^&]*$"
                    ErrorMessage="Please enter at least 6 characters consisting of at least 1 alphabet, 1 number & 1 special character" />
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>
                <asp:Label ID="Label11" runat="server" Text="Confirm Password*"></asp:Label><asp:TextBox ID="tbConfirmPw" runat="server" TextMode="Password"></asp:TextBox>
                <asp:RequiredFieldValidator runat="server" ControlToValidate="tbConfirmPw" CssClass="text-danger" ErrorMessage="The Confirm Password field is required." />
                <asp:CompareValidator runat="server" ControlToCompare="tbPassword" ControlToValidate="tbConfirmPw"
                    CssClass="text-danger" Display="Dynamic" ErrorMessage="The password and confirmation password do not match." />
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>
                Let us know if you prefer to receive notification via*
                <asp:RadioButtonList ID="rbNotifyVia" runat="server" vertical-Align="baseline" RepeatDirection="horizontal" TextAlign="right" RepeatLayout="Table" width="10px"  >
                  <asp:ListItem Value="Email" Text="Email" Selected="True"></asp:ListItem>
                  <asp:ListItem Value="SMS" Text="SMS"></asp:ListItem>
                </asp:RadioButtonList>        
            </asp:TableCell>
        </asp:TableRow>
        <asp:TableRow>
            <asp:TableCell>
                <asp:CheckBox ID="cbNews" runat="server" />Let us know if you like to opt in for THRIVE eNewsletter. <br />
                    &nbsp;&nbsp;&nbsp;&nbsp;The information that you provide is to help improve the THRIVE Program and to track your learning progress.
            </asp:TableCell>
            <asp:TableCell>
                &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<asp:Button ID="btnBack" runat="server" Text="Back" onClick ="Back_Click"/>&nbsp;&nbsp;&nbsp;&nbsp;<asp:Button ID="btnNext" runat="server" Text="Next" onClick="Validate_Click"/>
            </asp:TableCell>
        </asp:TableRow>
    </asp:Table>
    </article>
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